Agoraphobia
Agoraphobia or agoraphobia is one type of anxiety disorder. This disorder causes feelings of excessive fear and worry when in a place that makes the sufferer feel difficult to leave or feel unable to ask for help from anyone.
Usually, agoraphobia sufferers will feel panic and anxiety when traveling, on public transportation, in closed places (such as visiting shopping centers and cinemas), open places (for example, bridges and large parking areas), in crowded places, in queues, or leaving the house alone.
For this reason, sufferers usually avoid being in such places or conditions and it often becomes a reason that hinders social and work life.
Symptoms of Agoraphobia
Symptoms that occur in agoraphobia sufferers include:
- Rapid heartbeat.
- Rapid breathing.
- Feeling hot and sweaty or feeling cold.
- Feeling sick (not feeling well).
- Nausea or diarrhea.
- Chest pain.
- Swallowing disorder.
- Fear of dying.
However, broadly speaking, agoraphobia symptoms are classified into 3 types:
1. Physical symptoms
Physical symptoms of agoraphobia usually only occur when the sufferer is in a situation or environment that causes anxiety.
However, many people with agoraphobia rarely experience physical symptoms because they avoid situations that make them anxious.
In fact, the physical symptoms of agoraphobia are similar to panic attacks, namely:
- Rapid heartbeat.
- Rapid breathing (hyperventilation).
- Feeling hot and sweaty.
- Feeling sick.
- Chest pain.
- Difficulty swallowing.
- Diarrhea.
- Trembling.
- Dizzy.
- Ringing in the ears (tinnitus).
- Feeling weak.
2. Cognitive symptoms
Meanwhile, cognitive symptoms of agoraphobia are feelings or thoughts that are experienced but are not always related to physical symptoms.
Cognitive symptoms of agoraphobia may include fears that:
- Panic attacks will make you look stupid or feel embarrassed in front of others.
- A panic attack can be life-threatening, for example, you may worry that your heart will stop or that you won’t be able to breathe.
- You will not be able to escape from a place or situation if you are having a panic attack.
- Fear of losing sanity.
- Fear of losing control in public.
- You may tremble or blush in front of people.
- Afraid people might stare at you.
In addition, there are also psychological symptoms that are not related to panic attacks, such as:
- Feeling unable to function or survive without the help of others.
- Fear of being left alone at home.
- A general feeling of anxiety or fear.
3. Behavioral symptoms
Behavioral symptoms of agoraphobia include:
- Avoid situations that can trigger panic attacks, such as crowded places, public transportation, and queues.
- Staying at home, not being able to leave the house for a long time.
- It’s important to be with someone you trust wherever you go.
- Avoid being away from home.
- Some people are able to force themselves to face uncomfortable situations but feel very afraid and anxious when doing so.
Risk Factors for Agoraphobia
Here are some risk factors that can cause agoraphobia:
- Women are more likely to suffer from agoraphobia than men.
- Be in the age range of 25-30 years.
- Having a history of other psychiatric disorders, such as panic disorder, social anxiety disorder, other phobia, generalized anxiety disorder, and substance use disorders.
- Responding to panic attacks with too much fear and avoidance.
- Experiencing a stressful life event, such as abuse, death of a parent, or assault.
- Having an anxious or nervous personality.
- Having a blood relative with agoraphobia.
Causes of Agoraphobia
The exact cause of agoraphobia is still unknown.
However, experts suspect this is related to a history of panic disorder, anxiety disorders accompanied by panic, and being in certain situations that can trigger excessive fear.
Panic disorder itself is likely related to family history and previous traumatic events or stressors.
Diagnosis of Agoraphobia
Diagnosis of agoraphobia must be done by a psychiatrist. The doctor will ask about the complaints that occur, how often the complaints occur, and in what situations.
Often sufferers find it difficult to express their feelings, so it usually takes several meetings to establish a diagnosis of agoraphobia.
The diagnosis of agoraphobia is made based on the DSM-5 psychiatric diagnostic criteria. In the DSM-5, the diagnostic criteria for agoraphobia are excessive fear or anxiety triggered by definite or predictable exposure to 2 or more of the following situations:
- Using public transportation.
- Located in an open area.
- Located in a closed area.
- Standing in a queue or crowd.
- Going out of the house alone.
- Sufferers avoid the above situations because they believe they will feel trapped or unable to ask for help when they experience a panic attack.
- The above situations always cause panic or anxiety.
- The above situations are avoided, require help from those closest to you, or will result in very strong fear.
- Having a fear that is greater than the likelihood that harm will occur.
- The fear experienced or avoidance is persistent, lasting for 6 months or more. In addition, the fear experienced or avoidance causes significant distress.
- If another medical condition occurs (in addition to this disorder), then the fear or avoidance efforts will be even more excessive.
- The fear experienced or avoidance efforts cannot be explained by another medical disorder.
Agoraphobia Treatment
Treatment for agoraphobia usually involves a combination of treatment methods:
1. Psychotherapy
A psychological therapist can help overcome fears, using cognitive behavioral therapy (CBT).
A mental health professional or psychologist can help you identify the thoughts that make you anxious. Then, you can learn how to react more productively.
Using relaxation and desensitization techniques, a psychologist may have you imagine a frightening situation and manage your feelings.
Eventually, you will be able to engage in anxiety-provoking activities and will know how to manage your emotions.
Over time, therapy can train the brain to think and respond differently.
2. Medicines
A doctor or psychologist may also suggest taking medications called selective serotonin reuptake inhibitors (SSRIs), or serotonin norepinephrine inhibitors (SNRIs).
These drugs can treat depression and anxiety disorders.
3. Lifestyle changes
The following lifestyle changes can also help you overcome agoraphobia:
- Avoiding the use of alcohol, caffeine, and other substances.
- Eat a healthy and balanced diet.
- Exercise regularly.
- Do breathing exercises.
Complications of Agoraphobia
Agoraphobia can severely limit your daily activities. If your agoraphobia is severe enough, you may not be able to leave your house.
Without care, some people live in homes for years.
If this happens, you may not be able to visit family and friends, go to school or work, do homework, or participate in other daily routines.
Worse still, you may become dependent on others for help.
In addition, agoraphobia can also cause:
- Depression
- Alcohol or drug abuse.
- Having suicidal thoughts and attempts.
Agoraphobia Prevention
There is no surefire way to prevent agoraphobia. However, anxiety tends to increase the more you avoid the feared situation.
If you start to feel a little scared about going to a safe place, try practicing going to that place over and over again. This can help you feel more comfortable in those places.
If this is difficult to do, ask a family member or friend to accompany you, or seek professional help.
Meanwhile, if you have an anxiety disorder or are experiencing panic attacks, get treatment as soon as possible to prevent symptoms from getting worse.